Abstract

Introduction Defecating scintigraphic proctograms (DSPs) have an established position in the investigation of evacuatory problems and ano-rectal symptoms. Functional radionuclide imaging allows for both the assessment of rectoceles and correlation with evacuatory function.

Methods 151 consecutive DSPs carried out over a 3-year period were reviewed. Clinical details of presenting symptoms were reviewed with the study results. All studies were reviewed for evidence of anatomical abnormalities and function via % excretion. The % excretion was analysed in those with and without a rectocele and compared with symptoms (constipation, incontinence, rectal pain and evacuatory difficulty). The mean % excretion for each symptom (present/absent) was calculated and compared with a t test.

Conclusion In this large series DSPs identified rectoceles in 76% of studies. In those with a rectocele functional impairment was often present, with a trend to reduced % excretion seen. In those without a rectocele % excretion on DSPs did not differ in any symptom group. Larger reviews are needed to identify small sub-groups who may benefit from this study. The significant number with abnormalities found on DSPs suggests that this investigation may be underutilised in those with ano-rectal symptoms.

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